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At this point, I don't think it's well understood how many of the GOP's central health-care policy ideas have already been included as compromises in the health-care bill. But one good way is to look at the GOP's "Solutions for America" homepage, which lays out its health-care plan in some detail. It has four planks. All of them -- yes, you read that right -- are in the Senate health-care bill.

(1) "Let families and businesses buy health insurance across state lines." This is a long-running debate between liberals and conservatives. Currently, states regulate insurers. Liberals feel that's too weak and allows for too much variation, and they want federal regulation of insurers. Conservatives feel that states over-regulate insurers, and they want insurers to be able to cluster in the state with the least regulation and offer policies nationwide, much as credit card companies do today.

To the surprise and dismay of many liberals, the Senate health-care bill included a compromise with the conservative vision for insurance regulation. The relevant policy is in Section 1333, which allows the formation of interstate compacts. Under this provision, Wyoming, Colorado, Arizona, Utah, and Idaho (for instance) could agree to allow insurers based in any of those states to sell plans in all of them. This prevents a race to the bottom, as Idaho has to be comfortable with Arizona's regulations, and the policies have to have a minimum level of benefits (something that even Rep. Paul Ryan believes), but it's a lot closer to the conservative ideal.

(2) "Allow individuals, small businesses, and trade associations to pool together and acquire health insurance at lower prices, the same way large corporations and labor unions do." This is the very purpose of the exchanges, as defined in Section 1312. Insurers are required to pool the risk of all the small businesses and individuals in the new markets rather than treating them as small, single units. That gives the newly pooled consumers bargaining power akin to that of a massive corporation or labor union, just as conservatives want. It also gives insurers reason to compete aggressively for their business, which is key to the conservative vision. Finally, empowering the exchanges to use prudential purchasing maximizes the power and leverage that consumers will now enjoy.

(3) "Give states the tools to create their own innovative reforms that lower health care costs." Section 1302 of the Senate bill does this directly. The provision is entitled "the Waiver for State Innovation," and it gives states the power to junk the whole of the health-care plan -- that means the individual mandate, the Medicaid expansion, all of it -- if they can do it better and cheaper.

(4) "End junk lawsuits." It's not entirely clear what this means, as most malpractice lawsuits actually aren't junk lawsuits. The evidence on this is pretty clear: The malpractice problem is on operating tables, not in court rooms. Which isn't to deny that our current system is broken for patients and doctors alike. The Senate bill proposes to deal with this in Section 6801, which encourages states to develop new malpractice systems and suggests that Congress fund the most promising experiments. This compromise makes a lot of sense given the GOP's already-expressed preference for letting states "create their own innovative reforms that lower health care costs," but since what the Republicans actually want is a national system capping damages, I can see how this compromise wouldn't be to their liking.

(5) To stop there, however, does the conservative vision a disservice. The solutions the GOP has on its Web site are not solutions at all, because Republicans don't want to be in the position of offering an alternative bill. But when Republicans are feeling bolder -- as they were in Bush's 2007 State of the Union, or John McCain's plan -- they generally take aim at one of the worst distortions in the health-care market: The tax break for employer-sponsored insurance. Bush capped it. McCain repealed it altogether. Democrats usually reject, and attack, both approaches.

Not this year, though. Senate Democrats initially attempted to cap the exclusion, which is what Bush proposed in 2007. There was no Republican support for the move, and Democrats backed off from the proposal. They quickly replaced it, however, with the excise tax, which does virtually the same thing. The excise tax only applies to employer-sponsored insurance above a certain price point, and it essentially erases the preferential tax treatment for every dollar above its threshold.

(6) And finally, we shouldn't forget the compromises that have been the most painful for Democrats, and the most substantive. This is a private-market plan. Not only is single-payer off the table, but at this point, so too is the public option. The thing that liberals want most in the world has been compromised away.

On Sunday, John Boehner and Mitch McConnell responded to Barack Obama's summit invitation by demanding Obama scrap the health-care reform bill entirely. This is the context for that demand. What they want isn't a bill that incorporates their ideas. They've already got that. What they want is no bill at all. And that's a hard position for the White House to compromise with.

"For everyone to whom much is given, of him shall much be required." -- Luke 12:48

I had this discussion of bipartisanship with a friend of mine this AM. We find ourselves disagreeing on issues but can discuss them. Some of you on the left on this forum should try that.

We were talking of bipartisanship - my comment was it can only be bipartisan if both sides arrive on equal footing.

He came back with - the R's crammed it down the throats of the D's for the last 8 years - & I countered with Foley did the same, Rosty, O'Neill & Wright were no better, so it's not a Republican thing, it's a power thing .

Personally, I agree with the R's position, if they want them at the table it is not to discuss the bill that was cobbled together behind closed doors!

I am sure there may be something in the present bill worth salvaging but both my medical practitioners & myself seem to be satisfied with the present Mandatory government health plan I have. I just had my Rotator Cuff done, including stress tests & required medication it cost me less than $2k. When I had the Bypass done 14 years ago, I was out of pocket less than that & there have been few medical expenses in between. We actually spend more on the obligatory medical plan than we (the bride & I) spend on prescription medicines . We count our blessings knowing there are others, through no fault of there own are in a different position.

There are some things that could be done without a wholesale change, for us the Hopey - Changy thing is too much like the ribbon cutting ceremony at the local sewer plant. Bring it all to a central location so there can be a ribbon cutting ceremony rather than allowing each of us to have a septic system without the fanfare .

So much hand wringing about the Republicans. It's the Democrats in Congress that can't come together on health care. It's the Democrats in the House who can't agree with the Democrats in the Senate that held up and ultimately killed the bill.

Besides, the bill awaiting reconcilliation between the House and Senate was written entirely by Democrats and crafted behind closed doors. All Obama wants to do is tinker with that POS legislation, tweak it here and there and find a Republican or two to bite so he can crow that it's bipartisan. The GOP leaders in Congress should hold out for a complete rewrite...this time WITH their input. To do anything less makes them either the dog or the pony in Obama's Big Show.

Why didn't they pass it when they had the chance? Maybe because it is not liked by either side.......

Views and opinions expressed herein by Badbullgator do not necessarily represent the policies or position of RTF. RTF and all of it's subsidiaries can not be held liable for the off centered humor and politically incorrect comments of the author.
Corey Burke

Why didn't they pass it when they had the chance? Maybe because it is not liked by either side.......

Aint it amazing??
The leftys had control of the Executive Branch, the Legislative Branch, the Judicial Branch, the main stream network Media and the only thing they can do is blame Bush and the Republicans.

Hopefully you'll beg my pardon, Buzz, if I don't wade into your uber-lib blogger Ezra Klein's tome...as I'm sure you wouldn't bother wasting your time reading a Rush Limbaugh manifesto on health care. Suffice it to say, whatever putative "compromises" that may or may not be in the Senate version that Klein cites were most certainly NOT written for Republican consumption because at the time the legislation was written there was ZERO need to compromise with them and there was ZERO effort to compromise with them. Actually, not only were they not compromised with; they were scorned by Pelosi and Reid. I'm sure to Klein, anything less than cradle-to-grave nanny-state care for everyone (including illegal aliens), is a right wingnut concept, but common sense dictates that there's not much in that bill that a rank-and-file Republican would/could vote for (and the one Republican who did vote for it said he'd change his mind and vote against it if given another opportunity to do so).

The GOP leaders in Congress should hold out for a complete rewrite...this time WITH their input. To do anything less makes them either the dog or the pony in Obama's Big Show.

Over 200 republican provisions and amendments in the final senate bill. No public option. No medicare buy-in at 55. Sounds like they had some input to me? This is a 'no pre-condition' open invitation to dialogue, and as per their typical M.O., the republican leaders are obstructing, and saying "NO". That's not what they're elected for, and its not what they have a big fancy building in Washington for. And its surely not what we're paying them for.

Aint it amazing??
The leftys had control of the Executive Branch, the Legislative Branch, the Judicial Branch, the main stream network Media and the only thing they can do is blame Bush and the Republicans.

It's pretty damned funny if you think about it............

rk

Just when did the 'left' get control of the Judiciary? Did I miss that? The latest 5-4 ruling certainly was not a 'lefty one' was it?

JD

One cannot reason someone out of something they were not reasoned into. - Jonathan Swift

I had this discussion of bipartisanship with a friend of mine this AM. We find ourselves disagreeing on issues but can discuss them. Some of you on the left on this forum should try that.

We were talking of bipartisanship - my comment was it can only be bipartisan if both sides arrive on equal footing.

He came back with - the R's crammed it down the throats of the D's for the last 8 years - & I countered with Foley did the same, Rosty, O'Neill & Wright were no better, so it's not a Republican thing, it's a power thing .

Personally, I agree with the R's position, if they want them at the table it is not to discuss the bill that was cobbled together behind closed doors!

I am sure there may be something in the present bill worth salvaging but both my medical practitioners & myself seem to be satisfied with the present Mandatory government health plan I have. I just had my Rotator Cuff done, including stress tests & required medication it cost me less than $2k. When I had the Bypass done 14 years ago, I was out of pocket less than that & there have been few medical expenses in between. We actually spend more on the obligatory medical plan than we (the bride & I) spend on prescription medicines . We count our blessings knowing there are others, through no fault of their own are in a different position.

There are some things that could be done without a wholesale change, for us the Hopey - Changy thing is too much like the ribbon cutting ceremony at the local sewer plant. Bring it all to a central location so there can be a ribbon cutting ceremony rather than allowing each of us to have a septic system without the fanfare .

Good post, Marvin....gets down to where the rubber meets the road: the end user.